The GALAD score and the BALAD-2 score correlate with transarterial and systemic treatment response and survival in patients with hepatocellular carcinoma.

Dirk Forstmeyer, Timm Denecke, Daniel Seehofer, Florian Lordick, Anne Olbrich, Thomas Berg, Johannes Niemeyer, Hendrik Seiffert, Sebastian Ebel, Olga Gros, Sebastian Rademacher, Madlen Matz-Soja, Florian van Bömmel

Journal: Journal of cancer research and clinical oncology 2024;150(2):81

PMID: 38319485

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Abstract

PURPOSE

The GALAD score and the BALAD-2 score are biomarker-based scoring systems used to detect hepatocellular carcinoma (HCC). Both incorporate levels of alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP). Our objective was to examine the relationship between the GALAD score as well as the BALAD-2 score and treatment response to transarterial or systemic treatments in patients with HCC.

METHODS

A total of 220 patients with HCC treated with either transarterial (n = 121) or systemic treatments (n = 99; mainly Sorafenib) were retrospectively analyzed. The GALAD score and the BALAD-2 score were calculated based on AFP-L3, AFP, and DCP levels measured in serum samples collected before treatment. The results were correlated with 3-month treatment efficacy based on radiologic mRECIST criteria.

RESULTS

The GALAD score showed a strong correlation with BCLC stage (p < 0.001) and total tumor diameter before treatment (p < 0.001).The GALAD score at baseline was significantly lower in patients with a 3-month response to transarterial (p > 0.001) than in refractory patients. Among patients receiving systemic treatment, the median BALAD-2 score at baseline showed a strong association with response at month 3 (p < 0.001). In the transarterial treatment group, the GALAD score (AUC = 0.715; p < 0.001) as well as the BALAD score (AUC = 0.696; p < 0.001) were associated with overall survival, hereby outperforming AFP, AFP-L3 and DCP.

CONCLUSION

The GALAD score as well as the BALAD-2 score hold significant promise as a prognostic tool for patients with early or intermediate-stage HCC who are undergoing transarterial or systemic treatments.

Address: Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; Department of Diagnostic and Interventional Radiology, Leipzig University Medical Center, Leipzig, Germany.; University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany.; Department of Anesthesia and Intensive Care, Helios Clinic Köthen, Köthen, Germany.; University Cancer Center Leipzig (UCCL) and Division of Oncology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; Department of Visceral, Vascular, Thoracic and Transplant Surgery, Leipzig University Medical Center, Leipzig, Germany.; University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany.; Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; Rudolf-Schönheimer-Institute for Biochemistry, University of Leipzig, Leipzig, Germany.; Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany.; Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.; Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany. [email protected].; University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany. [email protected].; Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany. [email protected].

DOI: 10.1007/s00432-023-05526-z